Florida Senate - 2022                                     SB 678
       
       
        
       By Senator Cruz
       
       
       
       
       
       18-00101-22                                            2022678__
    1                        A bill to be entitled                      
    2         An act relating to prescription insulin drugs;
    3         creating ss. 627.64085 and 627.65746, F.S.; defining
    4         the term “prescription insulin drug”; requiring
    5         individual and group health insurance policies,
    6         respectively, to cap an insured’s monthly cost-sharing
    7         obligation for covered prescription insulin drugs at a
    8         specified amount; providing that coverage for
    9         prescription insulin drugs may not be subject to a
   10         deductible; providing construction; authorizing the
   11         Financial Services Commission to adopt rules; amending
   12         s. 627.6699, F.S.; requiring health benefit plans that
   13         cover small employers to comply with prescription
   14         insulin drug cost-sharing requirements; amending s.
   15         641.31, F.S.; defining the term “prescription insulin
   16         drug”; requiring health maintenance contracts to cap a
   17         subscriber’s monthly cost-sharing obligation for
   18         covered prescription insulin drugs at a specified
   19         amount; providing that coverage for prescription
   20         insulin drugs may not be subject to a deductible;
   21         providing construction; authorizing the commission to
   22         adopt rules; providing an effective date.
   23          
   24  Be It Enacted by the Legislature of the State of Florida:
   25  
   26         Section 1. Section 627.64085, Florida Statutes, is created
   27  to read:
   28         627.64085Cost sharing for prescription insulin drugs;
   29  limits.—
   30         (1)As used in this section, the term “prescription insulin
   31  drug” means a prescription drug that contains insulin, is used
   32  to treat diabetes, and has been prescribed as medically
   33  necessary by the treating physician.
   34         (2)A health insurance policy that provides coverage for
   35  prescription insulin drugs must cap the total amount of cost
   36  sharing required of an insured for covered prescription insulin
   37  drugs at an amount that does not exceed $100 for each 30-day
   38  supply, regardless of the amount or type of insulin needed to
   39  fill the insured’s prescription or prescriptions. Coverage for
   40  prescription insulin drugs may not be subject to a deductible.
   41         (3)This section does not preclude an insurer from reducing
   42  an insured’s cost-sharing obligation by an amount greater than
   43  the amount specified in subsection (2).
   44         (4)The commission may adopt rules to administer this
   45  section.
   46         Section 2. Section 627.65746, Florida Statutes, is created
   47  to read:
   48         627.65746Cost sharing for prescription insulin drugs;
   49  limits.—
   50         (1)As used in this section, the term “prescription insulin
   51  drug” means a prescription drug that contains insulin, is used
   52  to treat diabetes, and has been prescribed as medically
   53  necessary by the treating physician.
   54         (2)A group health insurance policy that provides coverage
   55  for prescription insulin drugs must cap the total amount of cost
   56  sharing required of an insured for covered prescription insulin
   57  drugs at an amount that does not exceed $100 for each 30-day
   58  supply, regardless of the amount or type of insulin needed to
   59  fill the insured’s prescription or prescriptions. Coverage for
   60  prescription insulin drugs may not be subject to a deductible.
   61         (3)This section does not preclude an insurer from reducing
   62  an insured’s cost-sharing obligation by an amount greater than
   63  the amount specified in subsection (2).
   64         (4)The commission may adopt rules to administer this
   65  section.
   66         Section 3. Paragraph (h) is added to subsection (5) of
   67  section 627.6699, Florida Statutes, to read:
   68         627.6699 Employee Health Care Access Act.—
   69         (5) AVAILABILITY OF COVERAGE.—
   70         (h) A health benefit plan that covers small employers which
   71  is issued or renewed on or after January 1, 2023, must comply
   72  with s. 627.65746.
   73         Section 4. Subsection (48) is added to section 641.31,
   74  Florida Statutes, to read:
   75         641.31 Health maintenance contracts.—
   76         (48)(a)As used in this subsection, the term “prescription
   77  insulin drug” means a prescription drug that contains insulin,
   78  is used to treat diabetes, and has been prescribed as medically
   79  necessary by the treating physician.
   80         (b)A health maintenance contract that provides coverage
   81  for prescription insulin drugs must cap the total amount of cost
   82  sharing required of a subscriber for covered prescription
   83  insulin drugs at an amount that does not exceed $100 for each
   84  30-day supply, regardless of the amount or type of insulin
   85  needed to fill the subscriber’s prescription or prescriptions.
   86  Coverage for prescription insulin drugs may not be subject to a
   87  deductible.
   88         (c)This subsection does not preclude a health maintenance
   89  organization from reducing a subscriber’s cost-sharing
   90  obligation by an amount greater than the amount specified in
   91  paragraph (b).
   92         (d)The commission may adopt rules to administer this
   93  subsection.
   94         Section 5. This act shall take effect January 1, 2023.